Non-Alcoholic Fatty Liver Disease

Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is an increasingly important cause of liver cirrhosis and liver cancer in the world. In Hong Kong, approximately 27% of the general population has NAFLD. Most patients are asymptomatic. Some patients may have elevated liver enzymes, but normal liver enzymes do not necessarily indicate mild disease. The disease can progress silently with increasing liver fibrosis and eventually develop into liver cirrhosis. NAFLD cannot be differentiated from alcohol-related liver disease by imaging or histology.

NAFLD is closely related to central obesity and metabolic disorders, including diabetes mellitus, hypertension and hyperlipidemia. Patients who have diabetes mellitus have higher risk of developing liver cirrhosis. About 3 in 4 patients with diabetes mellitus has fatty liver and 1 in 5 diabetic patients have advanced liver fibrosis. Liver cancer tend to develop in patients with liver cirrhosis, but up to 30% of liver cancer are found in fatty liver patients without liver cirrhosis. Weight reduction through dietary restriction and exercise is the most effective treatment. There is no specific pharmaceutical treatment for NAFLD, but several drugs have early data to reduce liver fat and fibrosis. The aim of managing NAFLD is to prevent the development of liver-related complications and to manage its associated metabolic disorders.